EFTA Document EFTA01448745

DB InSight Account Set Up Form (Use one form per user) All four sections of this form must be completed before access can be granted to DB InSight. After completing this form, please submit along with the other required signed documents to the DB InSight Help Desk : Mail Stop JCY03-0799, Tel: S Fax 1. Client/User Information: (MANDATORY) Client First and Last Name (as it appears on other legal documents): Users First and Last Name (person gaining access to the system) Jeffrey Epstein Users Address: (no P.O. Box - InSight kit is sent via FedEx) 6100 Red Hook Qtr, B3 Users Phone Number: (important for FedEx delivery) Users E-mail Address: Verification Hint: (Password Reminder) 2. Computer InfornAation: (Optional) Brand and Model of computer (IBM Aptiva. Compaq Presario, Dell Dimension, Apple Powerbook): Brand and Model of processor (Intel Pentium, Motorola G3): Operating System (Windows 3.1, 95. 98. NT: Mac OS 7, 8) System Memory (RAM ) in Megabytes (16MB. 32MB. 64MB): Internet service through (AOL, AT&T, internal network, EAU): Type/Speed of connection (56K Ethernet, ISDN, DSL, Cable): (minimum 56K required) Microsoft Internet Explorer (version 5.5, SP2) Saint Thomas U.S. Virgin Islands 00802 NA0S0D00014499-000102438 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0 103858 CONFIDENTIAL SDNY_GM_00250042 EFTA01448745